Investigating the causes of patient anxiety at induction of anaesthesia: A mixed methods study.
Andrew B Lumb, Gary J Latchford, Hilary L Bekker and 3 others
PMID 32638654WHAT IT FOUND
At anaesthetic induction, where induction happened, cannulation attempts, preoxygenation, alarm noise and staff responses did not predict patient anxiety or stress.
Patients said team introductions, chatting and explaining each step helped them cope.
Key findings
01The analysis found no significant predictive association between induction location, cannulation attempts, preoxygenation, alarm noise or staff responses and anxiety or stress.
02Only six of 40 patients registered a clinically severe anxiety response.
03Patients said being introduced to the team, friendly humour, distraction by conversation and being talked through the procedure helped them cope with anxiety.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was done in one hospital with a small number of patients, so it may not reflect other units or different theatre routines. Patients were chosen by convenience sampling, not random selection, so they may not represent all elective surgery patients. Anxiety was measured after surgery in the recovery area, not at the moment of induction, because patients were unconscious; this may make recall of pre-induction feelings less reliable. The study did not control preoperative information, anaesthetic interventions or staff behaviour, so it cannot show whether any single practice caused or reduced anxiety. Only ten patients were interviewed, so qualitative themes describe their experiences rather than a population effect. The investigators did not recruit by disease or operation, and all anaesthetics were supervised by experienced anaesthetists, which may limit how far results apply to other settings.
The easy way to misread this
Do not conclude that induction location, cannulation attempts, preoxygenation, alarm noise or staff responses cause anxiety at induction. The study found no significant association, but anxiety was measured after surgery and only 40 patients were observed at one centre, so it cannot prove these steps are harmless.